cirus
Forum Guru
Topics: 108
Posts: 740
|
1..A 25 years old caucasian man comes to the office due to 1 week hist of headache, running nose, nausea, fever & generral discomfort. His temp is 38.3C, physical exam shows evidence of mild meningeal irritation without other findings. Patient is informed that he needs to be admitted to perform some tests starting with lumbar puncture, but he refuses & wants to be discharged?
a. Let him go.
b. Counsel him about the risks of untreated meningitis, let him go & tell him he can always come back
c. Have him sign a paper that he knows he might die.
e. Explain everything over & over untill he agrees to stay.
2..A 42 years old caucasian male presents to u with a temp 40C, headache, & Vomiting. Physical exam--> Petich & Purpura over trunk & lower extremities. CSF--> Bact mening. The pt is told he needs to be admitted for proper ttt with ABs but he refuses & wants to go.
a. TTT against his wishes.
b. Discuss with his wife & get her approval.
c. Consult hosp committee
d. Respect pts decision & disharge with home ABs
e. Get a court order
|
| young_doc
Forum Guru
Topics: 55
Posts: 732
|
1. B
2. A? comfirmed meningitis, poses a risk to society??? i remember this Q but i don't remember the Answer! lol
___________________
First Aid is my Bible...
|
| GOGETA
I'm Dr. GOGETA
Topics: 300
Posts: 2,640
|
B sounds right but for some reason doesnt he need to sign a waiver?
___________________
As a general rule, the better it felt when you said it, the more trouble it's going to get you into.
|
| cirus
Forum Guru
Topics: 108
Posts: 740
|
yep ur right but in the 1st one isn't this a case of suspected mening & should be delt with in a better way??
|
| young_doc
Forum Guru
Topics: 55
Posts: 732
|
i totally agree... but out of the options given, it's the better one:
1. let him go --> well here you're not doing enough.
3. have him sign papers saying he might die --> this is overkill, u sholdn't tell the patient they might die!!!
4. explain things over and over --> clearly wrong.
___________________
First Aid is my Bible...
|
| cirus
Forum Guru
Topics: 108
Posts: 740
|
oh God im sorry guys but i missed writting one of the ans, It was
Force him to stay.
|
| ts97
Forum Senior
Topics: 13
Posts: 128
|
I got confused on these questinos in UW too. Why we let go the patient in the first case and treat him forsefully in the second case? Just because the Dx is confirmed in the second case?
|
| dr in trouble
Forum Guru
Topics: 60
Posts: 590
|
yes , in 2nd case u have to treat the pt bcoz pt is having meningococcal meningitis which is contagious and poses risk to society but in 1st case it can be viral or bacterial or something else.
___________________
If u want to do something, do it today as there is no tomorrow.
|
|
| |
| | | | | | | | |
